Date of Award


Document Type


Degree Name

Doctor of Health Administration


College of Health Professions

First Advisor

Annie N. Simpson

Second Advisor

Kit N. Simpson

Third Advisor

Dean E. Doering


Background: Periods of natural disasters like hurricanes can lead to traumas, worsening of existing medical conditions, travel restrictions, or healthcare systems’ inability to provide critical and timely care. A promising approach is telehealth use to provide care to remote patients in shelters or their homes. However, there is a need to better understand evacuees’ behavior and ED use during such events. Methods: We conducted a retrospective study using 2017 archival billing data in Florida during Hurricane Irma. The NYU ED algorithm was used to classify visits into emergent and non-emergent categories. Comparison groups included counties under mandatory evacuations and those with extended power outages. Comparison timelines were defined as pre-, post-, and hurricane quarters. Results: Hurricane evacuations caused more individuals to seek emergent and non-emergent care outside of their home counties during the hurricane quarter. Extended power outages caused an increase in in-county emergent and non-emergent visits after the hurricane. Telehealth could have potentially led to over $296 M in cost savings during the hurricane quarter. Discussion: Telehealth investments can be extended to meet the needs of a disaster-affected population. The availability of a robust telehealth infrastructure, appropriate planning and resource allocation, and supporting policies and regulation can make the continuity of care possible.


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